It is well-known sexual arousal and activity is a powerful hemodynamic stress .In the healthy persons it is never an issue .In fact there is data to suggest sexually active men and women live longer.
But , in patients with cardiac risk factors or an established coronary event unrestricted sex can be a risk factor for CAD.
There needs to be a distinction between a coronary risk factor and a coronary trigger .Trigger is an immediate switch for a coronary event in a patient with baseline risk profile .It is highly unlikely triggers alone can cause an ACS .There need to be risky substrate.
Extra marital sex could be such a trigger in some .(Both male and female)
- The sexual activity performed with guilt has more powerful risk.
- First time offenders
- New partners
- New environment
All of the above are supposed to increase the risk .
The mechanism attributable is a sudden adrenergic surge which inappropriately high when compared to marital sex . In conservative societies , the effort taken to hide the illicit relationship is much more stressful than the event itself. And hence these men and women carry on their new-found coronary risk for longer periods.